ORDER FORM
PRINT THIS FORM AND PHONE,
FAX, MAIL, or e-mail
INKWELL STATIONERS, INC.
Suite 500 Allegheny
Building ~ 429 Forbes Avenue ~ Pittsburgh, PA
15219
Phone:
412-434-7122 / Fax: 412-434-7133
/ e-mail: InkwellPA@aol.com
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________________________________________________________________________ STREET ADDRESS: ______________________________________________________________
CITY:
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STATE: ____________ ZIP
CODE: _____________ PHONE:
(________)____________________
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ITEM / FORM NUMBER
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QUANTITY
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PRICE
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SUBTOTAL:
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$ |
SHIPPING & HANDLING:
(Add $6.75 for
orders up to $25.00; $7.50 for orders
$25.01-$50.00;
$8.40 for orders
$50.01-$75.00; $9.90 for orders $75.01-$100.00;
Over $100.00 please call)
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$ |
| 7%
SALES TAX (IN PA.): |
$ |
| TOTAL: |
$ |
| Check
or Money Order enclosed: $
______________________________________________ |
| Charge
Card (Visa, Mastercard, American Express) (For Visa &Mastercard,
please give the 3 digit "V" number
found in the signature part on the back of your
card - The last 3 numbers_______):
#:
___________________________ Expiration Date:
_______ Signature: ______________________
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PLEASE INCLUDE PAYMENT WITH YOUR ORDER.
NO REFUNDS ON LEGAL DOCUMENTS OR CUSTOM-MADE
ORDERS PRICES AND FORMS ARE SUBJECT TO CHANGE
WITHOUT NOTICE
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Last Updated February 1,
2009 by CAL
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